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Sunday, September 7, 2008

New research found that obese people who have asthma are nearly five times more likely to be hospitalized for the problem and to have worse control of the disease and lower quality of life than those with asthma who are normal weight.

Researchers reported its findings in the September issue of The Journal of Allergy and Clinical Immunology, found other differences associated with obesity. Obese patients with asthma were 2.8 times more likely to have day-to-day problems with quality of life associated with their disease. They were 2.7 times more likely to have poor asthma control, too.

Researchers from Kaiser Permanente, Massachusetts General Hospital and Harvard Medical School have evaluated 1,113 adults with asthma, all members of Kaiser, in Oregon, Colorado or Washington.

They asked the patients about their height, weight, smoking habits, asthma treatment, other illness, and their quality of life associated with asthma, as well as their asthma control and any hospitalizations related to the condition. They also computed their body-mass index (BMI).

According to Dr. Michael Schatz, chief of the department of allergy at Kaiser Permanente, San Diego, and a clinical professor of medicine at the University of California, San Diego, School of Medicine, even accounting for all of those factors, there was a dramatic difference for obese asthmatics versus non-obese asthmatics. Moreover, he added, the most severe was a nearly five times greater risk for being hospitalized for asthma in the prior year. For information, obesity was defined as having a BMI of 30 or above.

According to Schatz, in previous research, obesity has been associated with having more intense asthma. In addition, Schatz added, for those who had asthma and were overweight but not obese, with a BMI of 25 to 29, the findings were not as clear. While the results for the overweight but not obese were not significantly different than for those of normal weight. Schatz said, "We probably could have used more numbers," explaining that the numbers of overweight but not obese persons may have been too small to tease out a difference. Moreover, he added, "I wouldn't want to conclude that being overweight [with asthma] is the same as normal weight in terms of risks."

According to Dr. Christopher Cooper, a professor of medicine and physiology at the David Geffen School of Medicine, University of California, Los Angeles, the study adds to the base of knowledge about asthma and weight. Moreover, he added, the study relied on large numbers overall, and the statistics are sound. One limitation is the lack of an intervention, such as following obese asthmatics that lose weight to see if their condition improves.

Exactly why obesity seems to make asthma worse is not discovered. Schatz and his colleagues speculated that obese people may have a lower self-image and not adhere to measures to make their asthma better, may not be as adherent to medication, or other factors.